Organization Name: | CHRYSALIS NEVADA, INC. |
NPI Number: | 1285738476 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARC ROBERT CHRISTENSEN (CHIEF OPERATIONS OFFICER) |
Mailing Address: | 223 W 520 N Orem |
State: | UT US |
Postal Code: | 840574696 |
Phone Number: | 8018051640 |
Fax Number: | 8018056733 |
NPI Enumeration Date: | 09/11/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |